Platelet activation in patients who underwent carotid versus coronary stent revascularization: behaviour during dual antiplatelet therapy and after thienopyridine discontinuation
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Data di Pubblicazione:
2010
Citazione:
Platelet activation in patients who underwent carotid versus coronary stent revascularization: behaviour during dual antiplatelet therapy and after thienopyridine discontinuation / M. Camera, P. Montorsi, M. Brambilla, D. Trabattoni, P. Canzano, S. Ghulam Ali, E. Tirloni, A. Bartorelli, E. Tremoli. ((Intervento presentato al 7. convegno Prospettive e innovazione nella ricerca cardiovascolare: dalla ricerca di base a quella clinica tenutosi a Napoli nel 2010.
Abstract:
Background. Platelet activation occurs in both coronary and carotid artery stenting as a result of vessel wall damage. The dual antiplatelet regimen (aspirin+thienopyridine) has a significant impact on reducing stent thrombosis and adverse outcomes. Whether differences exist in the degree of platelet activation among stent-treated coronary and carotid vessel is not known.
Aim. To compare platelet activation in patients who underwent carotid versus coronary revascularization. Methods. 20 patients with carotid stenosis and 20 stable angina patients who underwent BMS implantation were studied. To assess platelet function, blood was withdrawn 1 month (T1) after stenting procedure and 2 months after thienopyridine discontinuation (T2). Platelet activation markers (PAC1, CD62 and Tissue Factor [TF] and the % of monocyte-platelet aggregates [MPA]) were assessed by whole blood flow cytometry in resting conditions and upon in vitro ADP stimulation.
Results. One month after revascularization, CD62 and PAC1 positive (+) platelets were comparable in carotid and coronary-treated patients. By contrast, TF+ platelets as well as TF+ MPA were 3 fold higher in coronary vs carotid-treated patients, both under resting conditions and upon ADP stimulation (p<0.001). At T2 , when thienopyridine was discontinued, the platelet activation profile was comparable to that observed at T1, with TF+ platelets and TF+ MPA being still significantly higher (2-3 fold) in coronary vs carotid-treated patients, both under resting conditions and upon ADP stimulation (p<0.01). No significant differences in the platelet activation markers expression were observed between T1 and T2 both in carotid- as well as in coronary-treated patients.
Conclusions. Significant higher levels of TF+ platelets and TF+ MPA were observed in coronary patients who underwent revascularization with stent implantation compared to patients with carotid artery stenting, both 1 month after stenting and 2 months after thienopyridine discontinuation. This prothrombotic platelet phenotype may have implications for thrombotic complications in coronary patients.
Tipologia IRIS:
14 - Intervento a convegno non pubblicato
Keywords:
platelet activation; carotid stenting; coronary stenting
Elenco autori:
M. Camera, P. Montorsi, M. Brambilla, D. Trabattoni, P. Canzano, S. Ghulam Ali, E. Tirloni, A. Bartorelli, E. Tremoli
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